PATIENT INFORMATION: Breast Implants

patient´s checklist for breast implants: deutsch english francais espagnol
How does a breast implantation work
How to behave after breast surgery

WHAT … FOR? (Indications)
Breast implants change the outer contour of the breasts. They are used in the following circumstances:

  • cosmetic reasons
  • asymmetry
  • reconstruction amputation, for example in case of breast cancer
  • transsexuality

TIMES
Modern silicon implants are expected to keep for 15-20 years, but some have to be removed/replaced before. Some say they should be replaced every 10 years.

Several sites where the implant can be placed:

        PECTORAL MUSCLE  (red)

BEFORE              SUBGLANDULAR                SUBPECTORAL

A breast implant

RISKS

Short term risks:
As with all surgical interventions: Inflammation, repulsion, injury of neighbouring structures, foreign body reactions, allergic reactions, rejection, hematoma, asymmetry.

Long term risks:
Dislocation, chronic inflammation, chronic pain, nodularity, wrinkling, asymmetry, reoperation, scarring, implant removal.
Loss of breastfeeding ability as well as erotic sensation can occur, especially when accessing peri-areolar.

Aesthetic disappointment
The outcome can be planned very well today. Nevertheless, it may happen that the result does not meet the desired expectations. Then you have to decide whether you want to have it corrected.
For instance a Bottoming Out. This means the implant sitting too low and the nipple riding to high. It is correctable with additional surgery.

Seroma
Seroma means fluid around the implant. It will be removed simply by draining with a needle.

Capsular Contracture
This happens always to a certain degree. The capsule around the implant squeezes it and forms a fibrous acr tissue. This can be painful and is the most common complication. The scar tissue can be removed in an additional surgery, sometimes several times.

Necrosis
Dead tissue may very rarely develop around the implant. This tissue has to be removed, sometimes with the implant. It can leave permanent scars.

Interference with Mammography
Breast implants can obscure X-rays and make an evaluation more difficult.

Asymmetry

In the case of unilateral augmentation, one must expect that the breasts will become asymmetrical again over time, as the natural breast is more affected by aging processes than the one that has been treated.

Material-related problems

Rupture: Breast implants do not compromise daily life, but they are not indestructible. Most breast implants come with a lifetime manufacturer’s warranty that covers operational failure, but some events causing a rupture are not covered.

Anaplastic large cell lymphoma (BIA-ALCL) with certain textured breast implants.


breast contour implants come in many shapes and sizes

MATERIALS AVAILABLE

Artificial, synthetic

Tissue expander are used to prepare the space for a definite implant and to simulate the result.

Saline implants are vulcanized silicone elastomer filled with salt water 0.9%

Most breast implants are made of Silicone, a vulcanized silicone elastomer filled with silicone gel.

Implants have either a smooth or a textured surface. Smooth-walled implants are said to have a particularly natural “feel”; however, statistically, the rate of capsular fibrosis is higher for this type than for the implants with textured shell.

Autologous material

ALTERNATIVE

Breast augmentation with autologous fat has become established as an alternative. In this procedure, the specialist removes fat cells from a suitable part of the body and injects them into the breast after special preparation. The great advantage is the good tolerance of the body’s own tissue. However, breast augmentation using the patient’s own fat does not provide as significant an increase in size as breast implants.

NUMBERS / STATISTICS
Breast augmentation surgeries/year globally: 1,685,471 (2021)
Breast implant removal/year globally: 253,594 (2021) ⟨ISAPS statistics⟩
Some countries: Breast implants (2021) USA 378.000, Brazil 178.000, Japan 4.095, Mexico 77.700, Germany 67.000, Argentina 67.000, Turkey 49.000, India 31.600.

LITERATURE

– Problems

Problems with aesthetics are individually. The most common reason for changes is not medically or because of the material, but is done on request of the patient.
There have been material problems (ruptures) with PIP-implants and Rofil Medical Implants Ltd. These implants had to be removed/replaced and are no longer available.

MEDICAL SOCIETIES
see here

(as a patient you may watch for the patient information button in your regions language or the doctor finder button )

CRITICISM

SELECTED PATIENT INFORMATION

FDA about breast implants
FDA: Questions and Answers about Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)
Facts about Breast Implants D Zuckerman et al.
Wikipedia about breast implants
The UK’s Plastic Surgery Addiction – Infographic about plastic surgery addiction
BfAM: Brustimplantate aus Silikon – Allgemeine Hinweise und Risiken
Risiken von Silikonimplantaten e. V.

PATIENT CHECKLISTS

Questions to ask the surgeon about contour implants (english)
(deutsch)      (español)        (français)

How to behave after breast surgery

IMPLANT PATIENT REGISTER (links)

Australian Breast Device Registry (ABDR)
Breast and Cosmetic Implant Registry (BCIR, U.K.)
Bröstimplantatregistret of Sweden (BRIMP)
Dutch National Breast Implant Registry (DBIR)
National Breast Implant Registry (NBIR, U.S.A.)

In the register of the registries you can check which ones are available.

If your implant is not covered or if you don´t like national registers:
The Implant-Register offers registration of esthetic implants online (fee) and you can download a printable version (free) for your personal use. You can also ask your implanting doctor to register for you on the doctor’s page.

You can share your experience here for the community by submitting it for statistical purposes (personal data will remain anonymous). You may also post your experiences directly on some product sites.

Disclaimer
The information and links and whatsoever shown on this page are compiled with care. However, Implant-Register can´t take any responsibility for the information given, nor their content, nor their up-to-date nature, particularly in interlinked pages. You may help us with your contribution, granting us the decision to publish or not. Be careful with conclusions for yourself, in doubt double-check and consider medical solutions are individual and have to be found with an educated medical person.